Electronic cigarettes — myocardial infarction, hemodynamic compromise during pregnancy, and systolic and diastolic dysfunction: Minireview

Table 2 Arteriosclerosis and endothelial damage

Name of the study	Type of the study	Results	Comments
Modeling cardiovascular risks of ECs with human-induced pluripotent stem cell-derived endothelial cells	Randomized interventional on human endothelial cells; cells were exposed to EC flavoring products with and without nicotine	Flavoring e-liquids caused endothelial dysfunction even without nicotine; nicotine had a dose-dependent effect on cytotoxicity, reactive oxygen species generation, and apoptotic activities	In vitro study with limited implications
Flavorings in tobacco products induce endothelial cell dysfunction	Intervention study on human endothelial cells obtained from smokers and nonsmokers	The flavorings vanillin, cinnamaldehyde, eugenol, acetylpyridine, and menthol impaired nitric oxide production and increased expression of proinflammatory mediators and interleukin-6	Small study; the endothelial cells obtained by biopsy from 3 groups of 6 to 9 subjects
Vascular effects of a single bout of electronic cigarette use	Interventional nonrandomized study on healthy volunteers	There were no significant changes in heart rate, systolic and diastolic blood pressure, endothelial function (via flow-mediated dilation), and arterial stiffness (via cardio-ankle vascular index) throughout the experiments	Small study on 16 volunteers; the study was limited to acute changes post smoking one bout of ECs; flow mediated dilation and cardio-ankle vascular index may not be sensitive enough

ECs: Electronic cigarettes.